Page 32 - Exploring the Potential of Self-Monitoring Kidney Function After Transplantation - Céline van Lint
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Chapter 2
Patients’ experiences with using the measurement devices
The majority of patients considered using the creatinine and blood pressure devices to be pleasant (95% and 100%, respectively), useful (91% and 100%, respectively) and reassuring (63% and 76%, respectively). Trust in accuracy of the creatinine meter was significantly lower than trust in accuracy of the blood pressure meter (p <.001) (see figure 1). Based on the remarks patients made during the interviews (table 3, quote 1), we hypothesized that levels of unexplained variation in successive creatinine measurements might have resulted in lower levels of trust in the accuracy of the creatinine meter. To verify this, we calculated variation in creatinine measurements designated as the mean percentage change from successive measurements (i.e. difference between two measurements divided by their average). In line with the hypothesis a higher level of mean variation was related to a lower level of trust in the creatinine meter (p=.03). However, no associations were found between the amount of mean variation in creatinine results and whether using the creatinine meter was considered pleasant, reassuring or useful (p=.78, .71 and .57, respectively). The same analyses were conducted with regard to variations in successive measurements of Mean Arterial Pressure (MAP). Mean variation in MAP was neither related to trust in accuracy of the blood pressure meter (p=.86), nor to whether use of the blood pressure meter was considered pleasant, reassuring or useful (p=.88, .43 and .99, respectively).
Psychological measures: self-efficacy, perceived autonomy support and worries
Patients reported a high amount of trust in their own monitoring skills at baseline (M= 4.37, SD=.49) already and this did not change over time (p=.69; follow-up M=4.31, SD =.78). In line with this, interview data suggest that self-monitoring was perceived as very easy, with half of the patients (n=5) spontaneously mentioning the simplicity of the required actions, while none reported any difficulties (table 3, quote 2).
Although patients were generally satisfied with the level of autonomy support they received, (M=3.87, SD=.70) half of the interviewed patients (n=5) stated that their physicians had only limited interest in patients’ self-measured creatinine data. Despite the seemingly limited attention some physicians paid to the creatinine values measured at home, patients considered self-monitoring creatinine to be beneficial anyway (table 3, quote 3).
Physicians did, however, pay attention to patients’ self-measured blood pressure results (table 3 quote 4). In line with this, analysis of hospital records revealed that for 80% of our patients home- based blood pressure measurements were registered in the hospital system. On average, patients seemed to be somewhat worried about their transplantation, but these worries declined over time (baseline (M=2.98, SD=.88, follow-up M=2.38, SD=.82, p.=01).



























































































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